Pregnancy in the time of COVID-19: A retrospective review comparing
cases of in-utero death and placental abruption in 2020 to those in 2019
Abstract
Coronavirus disease 2019 (COVID-19) has a microembolic pathogenesis. We
reviewed the incidence of microembolic complications of pregnancy during
the COVID-19 pandemic period compared to the pre-pandemic period,
specifically in-utero death (IUD) and placental abruption. Design A
retrospective case review. Setting Patients were identified from the
Datix reporting system and anonymised data was collected from the
electronic health records. Population or Sample Women suffering an IUD
or placental abruption during the review periods. Methods A
retrospective review of the frequency and clinical characteristics of
cases of IUD and placental abruption between 1st Jan 2020 – 30th June
2020 was compared to those from the 1st Jan 2019 – 30th June 2019. Main
Outcome Measures To evaluate the frequency and clinical characteristics
of women suffering IUD and placental abruption during the pandemic
period in 2020, and compare them to the pre pandemic period in 2019.
Results There was a increase in the rates of IUD from 2019 to 2020,
1.22/1000 births compared to 2.85/1000 births (p= 0.10). There was no
difference in the rates of placental abruption (p= 0.03). Conclusions
Our review has demonstrated a non-significant rise in the frequency of
IUD in the pandemic period in 2020 compared to those in 2019.
Additionally, there was a significantly lower lymphocyte count during
the pandemic period- a marker known to be associated with COVID-19. This
warrants further investigation to explore the link between COVID-19 and
disorders of poor placental perfusion, particularly the rates of IUD.